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目的:探讨鼻咽癌患者外周血清可溶性CD4(sCD4)、可溶性CD8(sCD8)和可溶性ICAM—1(sICAM—1)的表达及其意义。方法:采用酶联免疫吸附测定法(ELISA)检测54例鼻咽癌患者治疗前、后血清sICAM一1、sCD4与sCD8水平。结果:鼻咽癌患者血清sICAM—1、sCD4及sCD8水平明显增高,与对照组比较,差异有极显著性意义(均P<0.01),血清sICAM—1浓度与TNM分期及淋巴结转移有关(均P<0.05),而sCD4、sCD8水平与淋巴结转移无关(均P>0.05);放疗终sCD4、sCD8与sICAM—1水平比放疗前明显降低(均P<0.01),但仍比对照组高(均P<0.01);放疗后6个月肿瘤全消组血清sICAM—1、sCD4与sCD8继续保持较低水平,与放疗前比较,差异有极显著性意义(均P<0.01);肿瘤残留组血清sICAM—1、sCD4与sCD8浓度出现不同程度回升,其中sICAM—1水平与肿瘤全消组比较,差异有极显著性意义(P<0.01),sCD4、sCD8浓度接近治疗前水平(均P>0.05),但比肿瘤全消组高(均P<0.05)。结论:鼻咽癌存在与sICAM—1表达相关的细胞免疫应答异常,血清sI—cAM—1、sCD4与sCD8的水平检测可作为鼻咽癌病情评估、疗效监测及随访的血清学指标。
Objective: To investigate the expression and significance of soluble CD4 (sCD4), soluble CD8 (sCD8) and soluble ICAM-1 (sICAM-1) in peripheral blood of patients with nasopharyngeal carcinoma. Methods: Serum levels of sICAM-1, sCD4 and sCD8 were measured in 54 patients with nasopharyngeal carcinoma before and after treatment by enzyme-linked immunosorbent assay (ELISA). Results: Serum levels of sICAM-1, sCD4 and sCD8 in patients with nasopharyngeal carcinoma were significantly higher than those in control group (all P <0.01). Serum sICAM-1 levels were correlated with TNM stage and lymph node metastasis (All P> 0.05). However, the levels of sCD4 and sCD8 were not associated with lymph node metastasis (all P> 0.05). The levels of sCD4, sCD8 and sICAM-1 in the end of radiotherapy were significantly lower than those before radiotherapy (All P <0.01). The levels of sICAM-1, sCD4 and sCD8 remained unchanged at 6 months after radiotherapy. The differences were statistically significant (all P <0.01) Serum levels of sICAM-1, sCD4 and sCD8 increased in different degrees. Among them, the levels of sICAM-1 were significantly different from those of patients with complete elimination (P <0.01). The concentrations of sCD4 and sCD8 were close to those before treatment (all P> 0.05), but higher than the total elimination of tumor (all P <0.05). CONCLUSIONS: There are abnormal cellular immune responses associated with the expression of sICAM-1 in NPC. Serum levels of sI-cAM-1, sCD4 and sCD8 can be used as a serological indicator to evaluate the disease status, monitor the curative effect and follow-up of nasopharyngeal carcinoma.